Application

Basic Research Immersion Training Experience (BRITE)

APPLICANT'S CONTACT INFORMATION

APPLICANT'S AFFILIATION

I am currently in the class of:

At which School or College of Veterinary Medicine (ex.K-State):

APPLICANT'S CERTIFICATION OF US CITIZENSHIP

I certify that I am a United States citizen or have permanent residency status in the United States. (NOTE: The NIH requires US Citizenship or permanent residency status for participants in the BRITE program)

APPLICANT'S STATEMENT OF COMMITMENT

Initial each statement below to indicate that, if selected as a BRITE Scholar, you agree to the following commitments.

I will commit to the full program without interruptions. (Standard vacation time will be available)

I will commit to work on my project and publish my research results under the direct guidance of my research mentor.

I will present the results of my research at KSU-CVM Phi Zeta Research Day.

I agree to follow the university rules and regulations pertaining to my work.

APPLICANT'S ACADEMIC CREDENTIALS

Please indicate previous degree(s) received:

BS

Major:

BA

Major:

MS

Area of Study:

PhD

Area of Study:

Are you currently in a combined DVM-Masters(MS or MPH) Program?

Are you currently in a combined DVM-PhD program?

APPLICANT'S TRANSCRIPTS

Please provide copies of your transcripts from undergraduate and professional coursework. Also provide copies of your MCAT or GRE scores (if taken). Unofficial copies are acceptable. These may be either attached here or emailed to bturner3@vet.k-state.edu.

Please include: "Transcript_Name of School" as filename if transcripts.

If you are a DVM student, please provide your current DVM GPA:

DVM GPA:

APPLICANT'S REFERENCES

Please ask two individuals familiar with your research potential to submit letters of reference to Dr. Bruce Schultz (c/o Barb Turner: bturner3@vet.k-state.edu). References may include faculty members from the veterinary college, undergraduate or other academic institutions attended by the applicant, as well as industrial scientists and/or other supervisors/employers. Please provide the names and contact information for your references in the spaces provided.

Reference: 1

Full Name:

Address:

E-Mail:

Phone Number:

Reference: 2

Full Name:

Address:

E-Mail:

Phone Number:

APPLICANT'S RESEARCH INTERESTS

Faculty members representing six departments/units at Kansas State University have agreed to participate in the BRITE veterinary student program.

Students may also seek training experiences with additional faculty members at Kansas State University or other institutions if prior approvals are obtained from the proposed research mentor, the BRITE program director (Dr. Schultz), and the National Institutes of Health. Dr. Schultz is available to facilitate laboratory placement for interested students.

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A) Research Focus

Please Indicate the research foci that interest you:

Epithelial Health and Disease:

Comparative Medicine:

Host-Pathogen-Enviorment Interface:

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B) Mentor Preference

Please select the appropriate statement in reference to your mentor selection for this program.

I have not yet identified a mentor. I will work with Dr. Schultz to do so, after acceptance into the BRITE program.

I have indicated one (or more) KSU mentor(s) from the list provided with whom I’d like to work with for this program.

PLEASE NOTE:

- BRITE Scholars are paid through a stipend and are not an employee of the Kansas State University College of Veterinary Medicine. This means no taxes are taken from the payment and the scholar will be responsible for income taxes as required by state and federal laws.

- GRA insurance is not available to scholars through the BRITE program

- The amount paid for the scholar’s tuition and fees is determined by their residency status.

APPLICANT'S RESEARCH INTERESTS

I have:

Provided contact informationAnswered questions about my affiliations, commitment and credentialsArranged for access/submission of my academic transcripts and test scoresRequested 2 letters of reference, and provided the names of those individualsIndicated my research interests/mentor preference in the spaces providedAttached statements about my research experience and long-term goals

By signing this document you are granting permission to obtain your academic record from CVM and share your application with faculty participating in the program, funding sponsors, and the program advisory committee.

If an error occurs, Please upload all file attachments again.

Signature HERE:

DATE:

If you would like to manually fill out this document and email it in, you can find a printable version here.